Difference between revisions of "Dermatopathic lymphadenopathy"
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{{ Infobox diagnosis | |||
| Name = {{PAGENAME}} | |||
| Image = Dermatopathic_lymphadenopathy_-_high_mag.jpg | |||
| Width = | |||
| Caption = Dermatopathic lymphadenopathy. [[H&E stain]]. | |||
| Micro = sinus histiocytosis with melanin pigment, esoinophils, plasma cells | |||
| Subtypes = | |||
| LMDDx = [[malignant melanoma]], [[sinus histiocytosis]], [[Hodgkin lymphoma]] | |||
| Stains = [[Fontana-Masson stain]] | |||
| IHC = | |||
| EM = | |||
| Molecular = | |||
| IF = | |||
| Gross = | |||
| Grossing = | |||
| Site = [[lymph node]] - see ''[[lymph node pathology]]'' | |||
| Assdx = T-cell lymphoma | |||
| Syndromes = | |||
| Clinicalhx = | |||
| Signs = enlarged lymph node | |||
| Symptoms = | |||
| Prevalence = uncommon | |||
| Bloodwork = | |||
| Rads = | |||
| Endoscopy = | |||
| Prognosis = benign | |||
| Other = | |||
| ClinDDx = other cause of lymphadenopathy | |||
}} | |||
'''Dermatopathic lymphadenopathy''', abbreviated '''DL''', is a rare [[lymph node pathology|pathology of the lymph nodes]]. | '''Dermatopathic lymphadenopathy''', abbreviated '''DL''', is a rare [[lymph node pathology|pathology of the lymph nodes]]. | ||
==General== | ==General== | ||
*Lymphadenopathy associated with a skin lesion - | *Lymphadenopathy associated with a [[skin]] lesion. | ||
*May be | **May not always be true.<ref name=pmid3178430>{{Cite journal | last1 = Gould | first1 = E. | last2 = Porto | first2 = R. | last3 = Albores-Saavedra | first3 = J. | last4 = Ibe | first4 = MJ. | title = Dermatopathic lymphadenitis. The spectrum and significance of its morphologic features. | journal = Arch Pathol Lab Med | volume = 112 | issue = 11 | pages = 1145-50 | month = Nov | year = 1988 | doi = | PMID = 3178430 }}</ref> | ||
*Benign in itself.<ref name=pmid17176922>{{Cite journal | last1 = Westhoff | first1 = TH. | last2 = Loddenkemper | first2 = C. | last3 = Hörl | first3 = MP. | last4 = Schmidt | first4 = S. | last5 = Anagnostopoulos | first5 = I. | last6 = Hummel | first6 = M. | last7 = Zidek | first7 = W. | last8 = van der Giet | first8 = M. | title = Dermatopathic lymphadenopathy: a differential diagnosis of enlarged lymph nodes in uremic pruritus. | journal = Clin Nephrol | volume = 66 | issue = 6 | pages = 472-5 | month = Dec | year = 2006 | doi = | PMID = 17176922 }}</ref> | |||
**May be associated with a malignancy - esp. T-cell lymphoma.<ref name=pmid5341844>{{Cite journal | last1 = Cooper | first1 = RA. | last2 = Dawson | first2 = PJ. | last3 = Rambo | first3 = ON. | title = Dermatopathic lymphadenopathy a clinicopathologic analysis of lymph node biopsy over a fifteen-year period. | journal = Calif Med | volume = 106 | issue = 3 | pages = 170-5 | month = Mar | year = 1967 | doi = | PMID = 5341844 }} | |||
</ref><ref name=pmid15173917>{{Cite journal | last1 = Kojima | first1 = M. | last2 = Nakamura | first2 = S. | last3 = Itoh | first3 = H. | last4 = Yamane | first4 = Y. | last5 = Shimizu | first5 = K. | last6 = Murayama | first6 = K. | last7 = Ohno | first7 = Y. | last8 = Tanaka | first8 = H. | last9 = Sugihara | first9 = S. | title = Clinical implication of dermatopathic lymphadenopathy among Japanese: a report of 19 cases. | journal = Int J Surg Pathol | volume = 12 | issue = 2 | pages = 127-32 | month = Apr | year = 2004 | doi = | PMID = 15173917 }}</ref> | |||
==Microscopic== | ==Microscopic== | ||
Latest revision as of 03:48, 10 December 2013
| Dermatopathic lymphadenopathy | |
|---|---|
| Diagnosis in short | |
 Dermatopathic lymphadenopathy. H&E stain. | |
|
| |
| LM | sinus histiocytosis with melanin pigment, esoinophils, plasma cells |
| LM DDx | malignant melanoma, sinus histiocytosis, Hodgkin lymphoma |
| Stains | Fontana-Masson stain |
| Site | lymph node - see lymph node pathology |
|
| |
| Associated Dx | T-cell lymphoma |
| Signs | enlarged lymph node |
| Prevalence | uncommon |
| Prognosis | benign |
| Clin. DDx | other cause of lymphadenopathy |
Dermatopathic lymphadenopathy, abbreviated DL, is a rare pathology of the lymph nodes.
General
Microscopic
Features:[5]
- Abundant histiocytes & special histiocytes - in loose irregular clusters - located in the sinuses, i.e. sinus histiocytosis - key feature:
- Do not form granuloma; may be similar to toxoplasma.
- Plasma cells (medulla).
- Eosinophils.
Histiocytes & special histiocytes:
- Histiocytes:
- +/-Melanin pigment key feature (if present).
- Lipid-laden macrophages.
- Interdigitating dendritic cells:
- Need IHC to identify definitively.
- Langerhans cells:
- Classically have a kidney bean nuclei.
- Need IHC to identify definitively.
DDx:
- Metastatic malignant melanoma - (melanin) pigmented cells have nuclear atypia, not histiocytes.
- Sinus histiocytosis - no cells with melanin.
Images
DL - very low mag. (WC)
DL - low mag. (WC)
DL - intermed. mag. (WC)
DL - high mag. (WC)
DL - very high mag. (WC)
IHC
- Interdigitating dendritic cells: S100 +ve, CD1a -ve.
- Langerhans cells: S100 +ve, CD1a +ve.
See also
References
- ↑ Gould, E.; Porto, R.; Albores-Saavedra, J.; Ibe, MJ. (Nov 1988). "Dermatopathic lymphadenitis. The spectrum and significance of its morphologic features.". Arch Pathol Lab Med 112 (11): 1145-50. PMID 3178430.
- ↑ Westhoff, TH.; Loddenkemper, C.; Hörl, MP.; Schmidt, S.; Anagnostopoulos, I.; Hummel, M.; Zidek, W.; van der Giet, M. (Dec 2006). "Dermatopathic lymphadenopathy: a differential diagnosis of enlarged lymph nodes in uremic pruritus.". Clin Nephrol 66 (6): 472-5. PMID 17176922.
- ↑ Cooper, RA.; Dawson, PJ.; Rambo, ON. (Mar 1967). "Dermatopathic lymphadenopathy a clinicopathologic analysis of lymph node biopsy over a fifteen-year period.". Calif Med 106 (3): 170-5. PMID 5341844.
- ↑ Kojima, M.; Nakamura, S.; Itoh, H.; Yamane, Y.; Shimizu, K.; Murayama, K.; Ohno, Y.; Tanaka, H. et al. (Apr 2004). "Clinical implication of dermatopathic lymphadenopathy among Japanese: a report of 19 cases.". Int J Surg Pathol 12 (2): 127-32. PMID 15173917.
- ↑ Ioachim, Harry L; Medeiros, L. Jeffrey (2008). Ioachim's Lymph Node Pathology (4th ed.). Lippincott Williams & Wilkins. pp. 226. ISBN 978-0781775960.